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Medicare Advantage - CMS to Recalculate Payment Year 2027 Star Ratings Following Recent Court Ruling
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Medicare Advantage - CMS to Recalculate Payment Year 2027 Star Ratings Following Recent Court Ruling
Equity Research
Flash Comment — June 17, 2026
Managed Care
Medicare Advantage - CMS to Recalculate
Payment Year 2027 Star Ratings Following
Recent Court Ruling
Our Call Stephen Baxter, CFA
This evening CMS announced it would voluntarily recalculate MA QBP ratings for the Equity Analyst | Wells Fargo Securities, LLC
Stephen.Baxter@wellsfargo.com | 212-214-8041
2027 plan year following a recent court ruling in favor of Clover. Our initial sense is that
James LemmisHUM will see a small benefit with UNH / CVS / ELV / CNC not impacted.
Associate Equity Analyst | Wells Fargo Securities, LLC
James.Lemmis@wellsfargo.com | 212-214-5336
Initial Thoughts Mitchell Ostrovsky
Stars Recalc. This evening CMS announced it is voluntarily recalculating Medicare Mitchell.Ostrovsky@wellsfargo.com | 212-214-7243
Advantage Quality Bonus Payment (QBP) ratings following a recent court ruling in favor
of Clover. The ratings were recalculated after removing all Part D Measures and certain
Part C measures. Plans are held harmless, so ratings can only improve vs. the original and
can't get worse. Plans with improved ratings will have an opportunity to resubmit 2027
bids but are not required to do so. Full memo included in body.
Our Take. We note that star ratings calculations are somewhat arduous to re-create
on a bottoms-up basis. Our initial sense is that for our coverage, the potential impacts
are small. Approximately ~2% of HUM's MA membership may move back into at least 4
star territory (H4141). Another ~3% of membership (H1951) appears to move from 4.0
to 4.5 stars. We don't believe UNH / CVS / ELV / CNC would have any increase to % of
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